Active NPI
Christine Martin, LICSW
- Social Worker
- Fargo, ND
National Provider Identifier
1801017389
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 3491
- Practice address
- 1112 Nodak Dr S
Fargo, ND 58103-2366 - Phone
- (701) 280-9545
- Fax
- (701) 280-9520
- NPI assigned
- May 1, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 3491 | ND | Primary |
Addresses
Primary practice location
1112 Nodak Dr S
Fargo, ND 58103-2366
Mailing address
1112 Nodak Dr S
Fargo, ND 58103-2366
Phone (701) 280-9545
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3491 | ND | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1801017389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1112 NODAK DR S",
"city": "FARGO",
"state": "ND",
"postal_code": "581032366",
"telephone_number": "701-280-9545",
"fax_number": "701-280-9520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1112 NODAK DR S",
"city": "FARGO",
"state": "ND",
"postal_code": "581032366",
"telephone_number": "701-280-9545",
"fax_number": "701-280-9520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "CHRISTINE",
"name_prefix": "Ms.",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "ND",
"license": "3491",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.